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Strategic Web Works
LLC
~Mail Order Form~
Please print out this form, fill it out
neatly, attach cash or money order, (NO CHECKS) and mail it to:
Strategic Web Works
P.O. Box 835
Clinton, MO 64735
This letter is to certify that I _________________________(please print)
under penalty of perjury, declare and affirm that I am over 18 years of age
and that it is legal for me to purchase the materials requested.
I also state that I am not an agent nor employee of
the U.S. Postal Service, police officer, nor work for, or are employed by
any local, city, county, state, government or federal agency. Nor am I
ordering or trading for these materials for the purpose of entrapment or any
sort of legal prosecution.
I also state that it is legal for me to purchase and
have sent to me the adult materials requested, and that it is not illegal in
the town, township, city, county, state or province where I reside or having
this mailed to.
I am not purchasing/ trading/ acquiring this material
to use against the seller/ trader/provider or any other person whatsoever in
any conceivable manner.
I will not permit any minor, or other person who might
find such material offensive to view or have access to this material.
I fully understand that I am requesting sexually
oriented materials. I further state that I am requesting these materials for
my own private use and will not trade/ sell these materials to other
parties. I am not affiliated with any nationwide distribution company or
business of any sort.
Please Sign: ___________________Date:_______
Date of Birth:________________
Ship To: (Please Print)
___________________________
___________________________
___________________________
Product Order
QTY____ TITLE_____________________________________________
PRICE_________
QTY____
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PRICE_________
QTY____ TITLE_____________________________________________
PRICE_________
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PRICE_________
QTY____
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PRICE_________
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PRICE_________
E-Mail ___________________________________ TOTAL________
Please include shipping per order:
USA-$6.00 / Canada-$10.00 / International-$20.00
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